Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stacey Ann Dimitriou-Ciaccio, RPAC

Individual provider Physician Assistant · NPI 1396788766

Stacey Ann Dimitriou-Ciaccio, RPAC is a Physician Assistant in Patchogue, New York. Qualified in 2003, 23 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
23
Licensed in
NY
In the registry since
2006
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Practice location Address checks out

101 Hospital Road Medical Ctr
Patchogue, NY 11772
Phone: (631) 687-2953
Fax: (610) 617-6280
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 009689 (NY)

Record details

NPI number1396788766
Entity typeIndividual (Type 1)
GenderFemale
Credentials RPAC
Sole proprietorNo
NPI enumeratedJune 14, 2006
Last updated in NPPESJuly 13, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Patchogue